Your ribs are thin bones, but they have an important job protecting your lungs, heart, and chest cavity. If you experience trauma to your chest, one or more ribs may be bruised, cracked, or fractured.
A bruised rib can take some time to heal, depending on the severity. It’s important to get your injury checked out by your doctor to rule out more serious injuries and learn about treatment options that can help your recovery.
Picture of bruised rib
It is hard to tell the difference between bruised ribs versus broken ribs. If you have difficulties breathing, immediately see a doctor. Photo: amyselleck | Flickr
What are the symptoms?
The main symptom of bruised ribs is chest pain. This pain may feel worse when you inhale. It may also hurt when you laugh, cough, or sneeze. Bending over or moving into other positions may also cause sharp chest pain.
Other symptoms can include:
- tenderness in the area of the bruise
- swelling around the bruised rib
- a bruise that’s visible on the skin
- spasms or twitching in your chest muscles
The symptoms of a broken rib are similar. If a rib is broken, you may hear a cracking sound when it happens, but only imaging tests can confirm the diagnosis.
The most typical cause of a bruised rib is a blow to your chest. This can happen in a car accident or during direct contact in a sport such as football. Falling from a ladder or other high place can bruise or break a rib, as can having something heavy fall on your chest.
Less common causes include excessive coughing or repetitive, strenuous activities, such as rowing or lifting heavy weights.
How it’s diagnosed
Diagnosing a bruised rib starts with a review of your symptoms and a physical exam. Your doctor will also listen to and watch your chest while you breathe to see if any lung function may have been affected. A bruised or broken rib may be accompanied by a bruise on your skin.
Whether a bruise is visible or not, your symptoms may require an X-ray. Your rib may have a slight fracture that isn’t detected with an X-ray. In these situations, a CT scan may help the doctor differentiate a break from a bruise.
Other diagnostic tools include a chest MRI. A rib bruise won’t show up on an X-ray, but it can often be detected with an MRI.
A bone scan can be particularly helpful in diagnosing a broken rib caused by repetitive action, such as excessive coughing or rowing, especially when it’s not visible on rib detail X-rays.
How it’s treated
Rib injuries are difficult to treat. Unlike a broken arm, for example, that can be set in a cast, a rib injury can’t be wrapped. The practice of wrapping your rib cage is seldom used these days because it restricts you from breathing deeply. Too much shallow breathing places you at risk of developing pneumonia.
Resting and restricting your activities are the main treatment options for bruised ribs. Ice may help relieve some of your pain and swelling.
Since bruised ribs cause pain when you inhale — causing you to take more shallow breaths — your doctor may prescribe medication to help manage your pain. Long-lasting anesthetic injections near the site of the bruise may also help temporarily keep your nerves there from relaying pain signals to your brain.
Your doctor may also advise respiratory therapy. You’ll learn breathing techniques that can reduce some of the pain, while still allowing you to fill your lungs with air.
How long does it take to heal?
Bruised ribs usually heal within a month or so, but that process can take longer if one or more ribs are actually broken instead of bruised. If you’re initially diagnosed with bruised ribs but the pain isn’t easing after a couple of weeks, tell your doctor. More imaging or another evaluation may be necessary.
When to see a doctor
Don’t hesitate to see your doctor if you experience any of these symptoms:
- rib pain when breathing or coughing, especially if you notice bruising or swelling and tenderness around your ribs
- worsening pain in the days or weeks after an injury
- shortness of breath
Even though there isn’t much you can do to help with the healing of your injury, you should still have a thorough evaluation of your ribs and lungs. Ignoring your pain could raise your risk of damaging your lungs or developing pneumonia or other serious respiratory problems.
Bruised ribs can be a painful injury with the potential to affect your lung health. They generally require time to heal and patience to put up with the pain. But if you follow your doctor’s advice, you should be able to fully recover.
There are safe ways to manage your pain. If you’re prescribed opioids or other strong medications, be sure to take them only as prescribed.
To help prevent bruised ribs in the future, wear proper padding when engaging in contact sports. You may also want to explore other activities or exercises that pose less of a threat to this important set of bones.